Organization
SOLOMON DERMATOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID B SOLOMON MD (OWNER)
(623) 974-3659
Entity
Organization
Contact information
Practice address
11361 N 99TH AVE, SUITE 201, PEORIA, AZ 85345-5470
(623) 974-3659
Mailing address
11361 N 99TH AVE, SUITE 201, PEORIA, AZ 85345-5470
(623) 974-3659
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11510
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2173735
AETNA ID
AZ
01
—
99S010800001
MEDISUN ID
AZ
01
—
AZ0853180
BC PROVIDER ID
AZ
Enumeration date
09/15/2006
Last updated
11/16/2007
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